There are many different types of formula available, including milk-based, soy-based, and hypoallergenic. Each of these different formulas contain all the protein, carbohydrates, vitamins, and minerals a baby needs to grow and develop. The majority of babies tolerate milk-based formulas such as Similac Advance, but some do not. If you are concerned your child is allergic to cow’s milk, please speak with one of our physicians and we can evaluate and recommend other options for formula, ie. a hypoallergenic formula, which is made from cow’s milk protein that has been broken down. Many babies with a cow’s milk allergy will also not be able to tolerate a soy-based formula due to cross-reactivity. Also, contrary to popular belief, babies do not develop a lactose intolerance at a young age. A true lactose intolerance is actually a quite rare disorder, and most of the time, lactose intolerance is developed later on in life.
Formula comes in powder, cans of concentrate, and ready-to-feed. The powder is easy to use and is the most economical. You can pre-measure the powder ahead of time into a small, dry container and then add it to a bottle of water when the baby is ready to eat. Concentrated formula is a liquid and needs to be diluted before using. Ready-to-feed works exactly how it sounds. However, it is expensive and thus, may be most beneficial to use only if your breast-fed baby requires a supplement when your milk is not available.
If you choose to supplement your breast milk with an infant formula, talk with my office staff or me first. Infant formula provide a safe and nutritionally complete alternative to breast milk. In some instances, we recommend supplementing with formula. These cases would include babies that are losing a bit more weight than we would like in the first week of life or babies that are more jaundiced.
The American Academy of Pediatrics recommends an iron-fortified infant formula as the only acceptable alternative to breast milk for the first 12 months of life. Whole cow’s milk and low-iron infant formulas should not be fed during a baby’s first year. Even if you choose to use infant formula for some feedings, you can still continue to breast feed. Many mothers find that a combination of breastfeeding and formula feedings works best for themselves and their baby.
Always mix the formula exactly as the label directs and never add extra water, concentrate, or powder. You can use regular tap water, bottled water, or boiled and cooled water to mix the formula. You do not need to sterilize the water. Make only the amount that your baby will take at a feeding so you will not waste formula. Store any opened concentrated formula in the refrigerator but for no more than 24-36 hours.
The amount your baby takes will vary. Your baby is probably getting enough calories if he or she is satisfied eating every 2 to 4 hours and has at least 6 wet diapers a day. Do not push your baby to finish the bottle if it is clear that she is full. Most babies feed for about 15-20 minutes. Bottle-fed baby stools will vary from brown and curdy, to brown with form, to brown and loose.
Formula switching is done for many reasons. The most common is for irritability, vomiting, spitting up, failure to gain weight, diarrhea, and rashes. If an allergy to the cow’s milk protein is suspected, switching to a soy-based formula can be recommended, however as mentioned before, it is possible that your baby will have allergy to soy-based formulas as well. Your baby may need to be switched to a hypoallergenic formula instead. Please contact us if you have questions about switching formulas.
A Schedule with Flexibility
A feeding schedule should be flexible, allowing your baby to eat when she becomes hungry. Very young babies usually need to be fed every 2 to 3 hours, but older babies may wait for 4 or 5 hours between feedings. Although crying is the only way a young baby can complain of hunger, crying may mean other things as well. If your baby cries within 2 hours after a feeding, check for other causes such as an uncomfortable position or wet diaper before feeding her again.
Burping Your Baby
Try to burp your baby during and after breastfeeding or bottle feeding. It’s also a good idea to try burping your baby halfway through a feeding. Burping helps remove swallowed air. To burp, hold the baby in an upright position so that her head is directly above her stomach. Sometimes a baby will not be able to burp, so don’t try to force one. Don’t be alarmed if your baby spits up a few drops of her feeding when being burped.